Granata A, Sobbrio G A, D'Arrigo F, Barillari M, De Luca P, Egitto M, Granese D, Pullè C, Trimarchi F
Institute of Clinica Medica I, University of Messina, School of Medicine, Italy.
Clin Exp Obstet Gynecol. 1991;18(1):9-12.
The physiological importance of proteins C and S as natural anticoagulants is demonstrated by the increased risk of thromboembolic disease among subjects with hereditary deficiency of both proteins. In the present study the effects were evaluated of low-dose oestrogen oral contraceptives (OC) on the plasma levels of immunological protein S, as free (PS-f), and in reversible complex with C4b-binding protein as well as functional protein C (PC) in a homogeneous group of 20 young healthy women. The participants were randomly given either gestodene (75 micrograms) or desogestrel (150 micrograms) in combination with ethinyl oestradiol (30 micrograms). Blood samples were taken prior to the initiation of the treatment and at the end of the sixth 21-day treatment cycle. The mean concentration of both free and bound PS fell significantly, the decrease still being within the reference range. Conversely, the plasma values for PC rose to a statistically significant extent. There were no significant differences between the two OCs. Hypothetically, the changes in PS-f (active fraction) might be conducive to a procoagulant state, which the increased PC may compensate. The reverse effect of two OCs on the activity of the protein C-protein S anticoagulant system might suggest a different regulation of their synthesis.
蛋白质C和S作为天然抗凝剂的生理重要性，在患有这两种蛋白质遗传性缺乏症的受试者中血栓栓塞性疾病风险增加这一点上得到了体现。在本研究中，对20名年轻健康女性组成的同质群体，评估了低剂量雌激素口服避孕药（OC）对免疫性蛋白质S的血浆水平的影响，包括游离形式（PS-f）以及与C4b结合蛋白形成可逆复合物形式的蛋白质S，还有功能性蛋白质C（PC）。参与者被随机给予孕二烯酮（75微克）或去氧孕烯（150微克）与炔雌醇（30微克）的组合。在开始治疗前以及第六个21天治疗周期结束时采集血样。游离和结合形式的PS的平均浓度均显著下降，下降后仍在参考范围内。相反，PC的血浆值在统计学上有显著升高。两种OC之间没有显著差异。假设，PS-f（活性部分）的变化可能有助于形成促凝状态，而PC增加可能会起到补偿作用。两种OC对蛋白质C - 蛋白质S抗凝系统活性的相反作用可能表明它们的合成存在不同的调节方式。
